Provider Demographics
NPI:1104594076
Name:FARR, TANYA
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:FARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 PENNEES PL
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1814
Mailing Address - Country:US
Mailing Address - Phone:916-213-8504
Mailing Address - Fax:
Practice Address - Street 1:321 N MALL DR STE 105
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7302
Practice Address - Country:US
Practice Address - Phone:435-673-1108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical